Unclear chronic vertigo syndromes-experiences with an interdisciplinary inpatient diagnostic concept

xlomafota13 shared this article with you from Inoreader Unclear chronic vertigo syndromes-experiences with an interdisciplinary inpatient diagnostic concept Via hno HNO. 2021 May 4. doi: 10.1007/s00106-021-01059-4. Online ahead of print. ABSTRACT Dizziness is a common leading symptom. Especially patients with chronic vertigo syndromes experience a significant impairment in quality of life up to a limitation of their ability to work in the case of employed persons. The consequences are financial and capacitive burdens on the health system due to frequently multiple examinations and sick leave up to occupational invalidity of the affected patient. In 150 patients with chronic vertigo syndromes and an unclear outpatient diagnosis, at least one diagnosis that justified the complaint was made in over 90% of cases on the basis of a structured interdisciplinary inpatient diagnostic concept. Chronic vertigo syndromes are often multifactorial. Psychosomatic (accompanying) diagnoses were found in more than half of the patients. Targeted therapy can only be recommended after establishing a specific diagnosis. This justifies an interdisciplinary inpatient diagnostic concept for persistently unclear cases. PMID:33944963 | DOI:10.1007 /s00106-021-01059-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Allogenes und autologes Material führt bei Mastoidhöhlenobliteration zu vergleichbaren Rezidivraten

xlomafota13 shared this article with you from Inoreader Allogenes und autologes Material führt bei Mastoidhöhlenobliteration zu vergleichbaren Rezidivraten Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1432-3123 Einleitung Bei symptomatischen Mastoidhöhlen nach Ohroperationen besteht die Therapie der Wahl in der chirurgischen Verkleinerung. Hierbei stehen verschiedene Methoden und Materialien zur Obliteration zur Verfügung. Allogenes Material ist leicht verfügbar, kann jedoch zu Wundinfektionen aufgrund von Abstoßungsreaktionen, Granulationen und Entzündungsreaktionen führen, weshalb autologes Material aufgrund seiner guten Biokompatibilität häufig bevorzugt wird. Ziel dieser Studie war es, die Langzeitergebnisse von Patienten nach Mastoidhöhlenobliteration mit allogenem und autologem Material im Hinblick auf das Auftreten von Rezidivcholesteatomen, die Anzahl der Revisionsoperationen und den Einfluss der Operation auf die Lebensqualität zu vergleichen.Methoden Patienten, die sich einer Mastoidhöhlenobliteration mit dem allogenen Material Hydroxylapatit-Matrix (HMM) unterzogen, wurden retrospektiv in die Studie eingeschlossen. In einem prospektiven Studienteil wurden Patienten eingeschlossen, welche sich einer Mastoidhöhlenobliteration mit autologem Rekonstruktionsmaterial (AutoM) unterzogen. Bei allen Patienten wurde neben einer ausführlichen Aktenanalyse eine Reintonaudiometrie durchgeführt und bei der postoperativen Untersuchung das Zürcher Mittelohrinventar (Zurich Chronic Middle Ear Inventory (ZCMEI-21)) zur Erhebung der gesundheitsbezogenen, krankheitsspezifischen Lebensqualität ausgefüllt.Ergebnisse Insgesamt wurden 22 Patienten mit einem durchschnittlichen Alter von 56,9 Jahren (SD 18,7 Jahre) und HMM (mittleres Nachuntersuchungsintervall: 88,3 Monate; SD 21,9 Monate) sowie 25 Patienten mit einem Durchschnittsalter von 52,4 Jahren (SD 13,7 Jahre) und AutoM (mittleres Nachuntersuchungsintervall: 13,5 Monate; SD 9,5 Monate) in die Studie eingeschlossen. Die audiologische Revisionsfreiheit lag nach einem Jahr für HMM bei 100% und für AutoM bei 85%. Die Rezidivfreihe it lag nach einem Jahr für HMM bei 95% und für AutoM bei 100%. Die Gruppen unterschieden sich weder hinsichtlich des postoperativen Hörergebnisses noch der postoperativen Lebensqualität.Diskussion Die Obliteration von Mastoidhöhlen ist eine chirurgische Herausforderung. Es zeigte sich kein relevanter Unterschied zwischen den verwendeten Materialien im Hinblick auf die Rezidivrate, das Hören und die Lebensqualität über den für beide Gruppen beobachteten Zeitraum von 13,5 Monaten. Die oft fehlende subjektive Symptomatik zusammen mit der hohen Rate an Rezidivcholesteatomen und Revisionsindikationen unterstreicht die Notwendigkeit einer regelmäßigen klinischen Nachsorge inklusive der Ohrmikroskopie bei chronischen Mittelohrerkrankungen und lässt regelmäßige Nachuntersuchungen dringend empfehlen. [...] Georg Thieme Verlag KG R� �digerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevention of cerebrospinal fluid leak after vestibular schwannoma surgery: a case-series focus on mastoid air cells' partition

xlomafota13 shared this article with you from Inoreader Prevention of cerebrospinal fluid leak after vestibular schwannoma surgery: a case-series focus on mastoid air cells' partition Via leak of cerebrospinal fluid Eur Arch Otorhinolaryngol. 2021 May 3. doi: 10.1007/s00405-021-06850-1. Online ahead of print. ABSTRACT BACKGROUND: Petrous bone pneumatization may be related to cerebrospinal fluid (CSF) leak secondary to vestibular schwannoma surgery. OBJECTIVE: To assess the association between petrous bone pneumatization and CSF leak in vestibular schwannoma surgery. METHODS: A retrospective study included 222 consecutive vestibular schwannoma patients treated via a retrosigmoid or translabyrinthine approach in a 17-year period in one University Hospital. Association of CSF leak and petrous bone pneumatization, as seen on CT scans, was assessed on ANOVA and Student's t or Chi-squared test in case of non-parametric distribution. RESULTS: One hundred and 75 resections were performed on a retrosigmoid approach and 47 on a translabyrinthine approach. Mean age was 53.6 ± 12.9 years. Mean follow-up was 5 years 6 months. Twenty-six patients (1 1.7%) showed CSF leak and 8 (3.6%) meningitis. Approach (p = 0.800), gender (p = 0.904), age (p = 0.234), body-mass index (p = 0.462), tumor stage (p = 0.681) and history of schwannoma surgery (p = 0.192) did not increase the risk of CSF leak. This risk was unrelated to mastoid pneumatization (p = 0.266). There was a highly significant correlation between internal acousticus meatus (IAM) posterior wall pneumatization and CSF leak after retrosigmoid surgery (p = 0.008). Eustachian tube packing in the translabyrinthine approach did not decrease risk of CSF leak (p = 0.571). CONCLUSION: Degree of petrous bone pneumatization was not significantly related to risk of CSF leak, but pneumatization of the posterior IAM wall increased this risk in retrosigmoid surgery. Eustachian tube packing in the translabyrinthine approach is not sufficient to prevent postoperative CSF leak. Both approaches had similar rates of CSF leaks, around 12%. PMID:33942123 | DOI:10.1007/s00405-021-06850-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The adjunctive use of carbimazole during radioactive iodine treatment reduces the cure rate of Graves' disease

xlomafota13 shared this article with you from Inoreader The adjunctive use of carbimazole during radioactive iodine treatment reduces the cure rate of Graves' disease Via radioactive iodine S Afr Med J. 2021 Feb 1;111(2):176-179. doi: 10.7196/SAMJ.2021.v111i2.14522. ABSTRACT BACKGROUND: Radioactive iodine (RAI) is widely used in the treatment of hyperthyroidism. Adjunctive antithyroid drugs (ATDs) are commonly prescribed to treat the hyperthyroid state before the RAI has taken effect. However, there is no consensus on the use of or timing of adjunctive ATD treatment with RAI. OBJECTIVES: To determine the influence of the ATD carbimazole on the cure rate of RAI t reatment for Graves' disease. METHODS: A retrospective chart review was conducted in the Department of Nuclear Medicine of the Steve Biko Academic Hospital in Pretoria. The cure rate of patients treated with RAI for Graves' disease was analysed. The effect of adjunctive carbimazole treatment with regard to its use and timing with RAI dosing was analysed. The cure rate was determined in patients treated with carbimazole either before RAI or before and after RAI administration. Cure rate was defined by the biochemical thyroid function status (thyroxine (T4), thyroid-stimulating hormone (TSH)) as euthyroid or hypothyroid from 3 months and sustained at 12 months. The need for a second dose of RAI was recorded. RESULTS: RAI treatment was administered to 171 patients with Graves' disease. The cure rate was higher in patients receiving a higher dose of RAI. The overall cure rate increased progressively from 3 months and was 91% at 12 months. The cure rate in 97 patients not rec eiving carbimazole was 98%. The cure rate of the 27 patients on carbimazole treatment given before RAI administration was 81%, and 73% in the 37 patients in whom it was resumed after RAI administration. The overall cure rate was lower in patients who received carbimazole (p<0.001), but especially in patients in whom carbimazole was continued after RAI administration (p<0.001). CONCLUSIONS: Adjunctive carbimazole treatment decreased the RAI cure rate of Graves' disease significantly. PMID:33944730 | DOI:10.7196/SAMJ.2021.v111i2.14522 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pediatric follicular bronchiolitis with severe atelectasis: a case report

xlomafota13 shared this article with you from Inoreader Pediatric follicular bronchiolitis with severe atelectasis: a case report Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Apr 15;14(4):526-532. eCollection 2021. ABSTRACT Follicular bronchiolitis is a rare pulmonary disorder characterized by the presence of multiple hyperplastic lymphoid follicles with a peribronchiolar distribution. An 11-year-old girl with total atelectasis of the right middle lobe (RML) and diffuse multiple small nodules at both lung bases presented to our hospital with frequent upper respiratory infections and pneumonia. The disease progressed during a 3-month period of macrolide therapy, and thoracoscopic biopsy with lobectomy of the atelectatic RML was performed. The histopathologic diagnosis was follicular bronchiolitis. The patient's pulmonary function improved dramatically after oral steroid treatment. It can be difficult to diagnose follicular bronchiolitis based solely on clinical, laboratory, and radiologic findings; the disorder must be confirmed histopathologically. A patient with longstanding irr eversible atelectasis and resulting recurrent respiratory infection may require lobectomy for the diagnosis and treatment of follicular bronchiolitis. PMID:33936377 | PMC:PMC8085817 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

EphA2 as a new target for breast cancer and its potential clinical application

xlomafota13 shared this article with you from Inoreader EphA2 as a new target for breast cancer and its potential clinical application Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Apr 15;14(4):484-492. eCollection 2021. ABSTRACT PURPOSE: The aim of this research was to study the expression of EphA2 to assess its suitability as a new breast cancer target. METHODS: Immunohistochemistry (IHC) was used to detect EphA2 protein expression in pathology tissue samples from 250 cases of breast cancer, and the expression of EphA2 mRNA was detected by in situ hybridization (ISH). Breast cancer cells were isolated and cultured. The expression of EphA2 in the cells was detected by the indirect immunofluorescence assay (IFA), and the expression of EphA2 in breast cancer was analysed. RESULTS: EphA2 protein and mRNA were mainly expressed in tumor cells and vascular endothelial cells. EphA2 protein was expressed in 187 cases, with a positive rate of 74.80%, whereas EphA2 mRNA was expressed in 209 cases, with a positive rate of 83.60%. EphA2 protein and mRNA expression were correlated with lymph node metastasis, clinical stage, and breast cancer histologic grade (P<0.05). In addition, the positive expression rates of EphA2 protein and EphA2 mRNA were correlated (P<0.05). EphA2 was barely expressed in normal breast cells but highly expressed in breast cancer cells. CONCLUSION: EphA2 is highly expressed in breast cancer tissues and has the potential to be a new breast cancer target, providing a preliminary basis for the development of new targeted drugs for breast cancer and the construction of fluorescent-targeted tracers for fluorescence-guided mastoscopic breast-conserving surgery. PMID:33936371 | PMC:PMC8085825 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Castleman's disease of the left parotid gland: a case report

xlomafota13 shared this article with you from Inoreader Castleman's disease of the left parotid gland: a case report Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Apr 15;14(4):533-537. eCollection 2021. ABSTRACT Castleman's disease is a very rare heterogeneous group of lymphoproliferative disorders characterized by non-neoplastic growths. It is unknown about the pathophysiology of the Castleman's disease. Previous studies demonstrated that Castleman's disease can be divided into two groups according to clinical classification, including unicentric Castleman disease (UCD) and multicentric Castleman disease (MCD). The hyaline vascular type is most common in the head and neck, and is abbreviated as UCD. In the present case, a woman complained that a mass in her parotid gland was growing and it was painless seven months ago. The computed tomography (CT) showed that the superficial lobe of the parotid gland on the left had an elliptical soft tissue density shadow, about 2.5×3.5 cm, with clear boundaries and no obvious abnormalities in the surrounding bone. The CT scan sho wed no obvious abnormalities in the shape and density of the right parotid and bilateral submandibular glands. After the operation, combined with the results of immunohistochemistry, the final diagnosis was Castleman tumor. The patient recovered smoothly, after the operation and during follow-up. The patient maintained good health without recurrence or metastasis. PMID:33936378 | PMC:PMC8085830 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reduced circulating exosomal miR-382 predicts unfavorable outcome in non-small cell lung cancer

xlomafota13 shared this article with you from Inoreader Reduced circulating exosomal miR-382 predicts unfavorable outcome in non-small cell lung cancer Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Apr 15;14(4):469-474. eCollection 2021. ABSTRACT Circulating microRNAs (miRNAs) have been demonstrated as robust and promising biomarkers for non-small cell lung cancer (NSCLC). Our aim was to determine the significance of serum exosomal miR-382 in NSCLC. Circulating exosomes were collected from 126 patients with NSCLC and 60 normal controls before treatment and one month after surgery. The circulating exosomal miR-382 expression was measured with quantitative RT-PCR (qRT-PCR) in all the participants. Our findings demonstrated that circulating exosomal miR-382 was very reduced in NSCLC. In addition, it showed high accuracy for discriminating NSCLC patients from healthy subjects. Interestingly, serum exosomal miR-382 improved the diagnostic accuracy of carcinoembryonic antigen (CEA). Moreover, its level increased significantly one month following surgical resection. Reduced circulating exosomal miR-382 was po sitively associated with poor clinical variables. NSCLC cases with lower serum exosomal miR-382 suffered worse overall survival (OS) and serum exosomal miR-382 was independently associated with OS. Taken together, circulating exosomal miR-382 is a robust biomarker for evaluating the progression of NSCLC. PMID:33936369 | PMC:PMC8085833 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Giant osteochondroma of ilium: a case report and literature review

xlomafota13 shared this article with you from Inoreader Giant osteochondroma of ilium: a case report and literature review Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Apr 15;14(4):538-544. eCollection 2021. ABSTRACT Osteochondroma is one of the most common benign bone tumors. It usually grows on the metaphysis of long bones and rarely develops in bones of scapula, feet, hands, and pelvis. The management of this disease is en-bloc excision of the tumor. We present a 45-year-old female subject, who complained of having found a mass on the right hip for more than 20 years which was diagnosed to be osteochondroma on X-ray, computed tomography (CT) and 3-dimensional (3-D) reconstruction. We performed en-bloc excision for the patient. Pathologic examination of surgical specimen confirmed the diagnosis of osteochondroma. The patient made a complete recovery and there has been no recurrence after one year of follow-up. Osteochondroma usually represents an osteo-cartilaginous aberrant overgrowth of normal epiphyseal growth plates. The disease has a slow onset and a long history. X -rays and CT scans are sufficient for diagnosis before surgery and the final diagnosis should based on pathology. Differential diagnosis includes chondrosarcoma or other neoplasms. When osteochondroma causes pain, compression of peripheral nerves, or continuous growth and other clinical symptoms, en-bloc excision of the tumor is needed. Better recognition and more comprehensive evaluation of these rare cases should be highlighted to avoid misdiagnosis during our clinical practice. PMID:33936379 | PMC:PMC8085818 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Relationship between histologic changes and inflammatory markers in chronic rhinosinusitis

xlomafota13 shared this article with you from Inoreader Relationship between histologic changes and inflammatory markers in chronic rhinosinusitis Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Apr 15;14(4):501-507. eCollection 2021. ABSTRACT The present study aimed to elucidate the relationship between histologic changes and inflammatory markers in chronic rhinosinusitis (CRS). Inflammatory markers of CRS, including eosinophil and neutrophil counts, the eosinophil-to-lymphocyte ratio, and the neutrophil-to-lymphocyte ratio, were investigated in tissues and peripheral blood. Inflammatory markers were evaluated according to the histologic changes of stromal edema, stromal fibrosis, and basement membrane (BM) thickening. Among 92 patients with CRS who underwent pathologic examinations, stromal edema, stromal fibrosis, and BM thickening were identified in 84.8%, 25.0%, and 53.3% of patients, respectively. Stromal edema and BM thickening were observed more frequently in CRS with nasal polyps than in CRS without nasal polyps (P = 0.001 and P = 0.001, respectively). Tissue inflammatory mark ers differed according to the presence of histologic changes in tissues. In peripheral blood, however, only the eosinophil count differed according to BM thickening. Patients with two or more histologic changes had higher tissue eosinophil-to-lymphocyte ratios (P = 0.008) and eosinophil counts (P = 0.002) compared with subjects with no or one histologic change. Conversely, the tissue neutrophil-to-lymphocyte ratio and neutrophil count were higher in patients with no or one histologic change than in patients with two or more changes. Collectively, tissue inflammatory markers may be correlated with histologic changes in CRS. However, serum inflammatory markers have a limited ability to predict histologic changes in patients with CRS. PMID:33936373 | PMC:PMC8085832 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic value of the nodal yield in elective neck dissections in patients with head and neck carcinomas

xlomafota13 shared this article with you from Inoreader Prognostic value of the nodal yield in elective neck dissections in patients with head and neck carcinomas Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 3. doi: 10.1007/s00405-021-06819-0. Online ahead of print. ABSTRACT PURPOSE: The objective of this study is to assess the prognostic capacity of the nodal yield in elective neck dissections performed in patients with head and neck squamous cell carcinomas (HNSCC) without clinical or radiological evidence of regional involvement (cN0) at the time of diagnosis. METHODS: Retrospective study including 647 patients with HNSCC treated with an elective neck dissection. RESULTS: Patients with < 15 dissected nodes (n = 172, 26.6%) had a 5-year disease-specific survival of 64.9% (95% CI: 57.3-72.5%), while for patients with ≥ 15 dissected nodes (n = 475, 73.4%), it was of 81.9% (95% CI: 78.4-85.4%) (P = 0.0001). The nodal yield category had prognostic capacity on the disease-specific survival in patients with tumors located in the oral cavity (P = 0.001), the oropharynx (P = 0.023) and the hyp opharynx (P = 0.034), while for patients with tumors located in the larynx, no significant differences appeared (P = 0.779). Differences in regional recurrence-free survival were also observed based on the nodal yield category in patients with extra-laryngeal tumors (5-year regional recurrence-free survival of 81.0% in patients with < 15 dissected nodes vs 89.0% in patients with ≥ 15 dissected nodes; P = 0.046). CONCLUSION: The nodal yield in elective neck dissections in patients without evidence of lymph node disease (cN0) had prognostic capacity depending on the location of the primary tumor. For tumors located in the larynx, the number of dissected nodes did not significantly influence the prognosis. For tumors located in the oral cavity, oropharynx or hypopharynx, patients with < 15 dissected nodes had a disease-specific mortality 2.9 times higher than patients with ≥ 15 dissected nodes. PMID:33938992 | DOI:10.1007/s00405-021-06819-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.